Comparison of the MyoRing implantation depth by mechanical dissection using PocketMaker microkeratome versus Melles hook via AS-OCT

Abstract

BackgroundThis paper seeks to evaluate the depth and outcomes of MyoRing implantation using two mechanical dissection procedures including: PocketMaker microkeratome in opposition to the Melles hook method.MethodsThis retrospective study was carried out on 39 eyes of 38 keratoconus patients (28 male and 10 female) with the mean age of years and had undergone MyoRing implantation by the two mentioned methods. The MyoRing was inserted into the corneal pocket which was made manually in 18 eyes (Melles hook group) or with PocketMaker microkeratome in 21 eyes (PocketMaker group). The mean follow up time was months with pre-operative and post-operative ophthalmic examination including uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), keratometry readings and central corneal thickness measurement. AS-OCT (Casia, SS-1000, Tomey, Nagoya, Japan) imaging was used to measure MyoRing insertion depth, exactly.ResultsPre-operative and post-operative UCVA (LogMAR) mean change for the PocketMaker and Melles hook groups were recorded at 0.75 ± 0.32 and 0.78 ± 0.33, respectively. Similarly, BCVA (LogMAR) mean change were 0.27 ± 0.22 and 0.23 ± 0.22. Mean keratometry (Kmean) change were 6.06 ± 4.18 and 6.56 ± 3.55 respectively. UCVA change (P = 0.767), BCVA change (P = 0.77) and Kmean change (P = 0.693) showed that there was no statistically significant difference between both groups for any parameter. Depth measurements achieved from AS-OCT images showed that there was no statistically significant difference in pocket depth between two methods of MyoRing implantation (P = 0.413).ConclusionsThe results of Myoring implantation outcomes using mechanical dissection via PocketMaker microkeratome as against Melles hook are comparable.

Bioengineered corneal tissue for minimally invasive vision restoration in advanced keratoconus in two clinical cohorts

“…3 ). Femtosecond laser-assisted surgery was used to ensure accuracy and reproducibility, but intrastromal pocket creation can be achieved manually without a laser 45 , 46 .…”

Combined Corneal Cross-Linking and Myoring Implantation in Advanced Keratoconus: Femtosecond Laser versus Manual Dissection

“…Mean keratometry reduction was 6.1 ± 0.4 and 6.2 ± 3.55 in the PocketMaker and Melles hook, respectively. UCVA change ( P = 0.76), CDVA change ( P = 0.77), and K-means change ( P = 0.69) showed that there was no statistically significant difference between both groups for any parameter [ 10 ].…”

“…The concept of a full corneal intrastromal ring as an additive refractive technique for the correction of myopia was first proposed by Reynolds in 1978 [ 6 ]. Extensively enhanced by Daxer [ 7 ], implantation of a full corneal intrastromal implantation system (CISIS) has been considered for KC management [ 8 – 10 ].…”